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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Descriptive epidemiology of cholangiocarcinoma and clonorchiasis in Korea.

In 2009, infection with the liver fluke Clonorchis sinensis (C. sinensis) was classified as "carcinogenic to humans" (Group 1) based on its involvement in the etiology of cholangiocarcinoma by the International Agency for Research on Cancer.

However, little is known about the descriptive epidemiology of cholangiocarcinoma in Korea.

Cholangiocarcinoma incidence rates are currently rising, even while primary liver cancer incidence rates are decreasing.

Annual percent changes in cholangiocarcinoma incidence rates were 8% for males and 11% in females.

Known areas of C. sinensis endemicity showed high incidence rates of cholangiocarcinoma.

From a meta-analysis, the summary odds ratio for cholangiocarcinoma due to C. sinensis infection was 4.7 (95% confidence interval: 2.2-9.8).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Liver transplantation for incidental cholangiocarcinoma: analysis of the Canadian experience.

Cholangiocarcinoma is a biliary tumor, which not infrequently complicates primary sclerosing cholangitis.

The goal of this retrospective study was to perform a national review of outcomes after liver transplantation in Canadian recipients found to have incidental cholangiocarcinoma in their explanted native liver.

Six of the seven liver transplant centers in Canada provided clinical and follow-up information on all liver transplant recipients found to have incidental cholangiocarcinoma in their explants.

The diagnosis or suspicion of cholangiocarcinoma prior to transplantation were exclusion criteria for this study.

Ten individuals with cholangiocarcinoma were transplanted between 1996 and 2003.

In conclusion, although early survival of patients transplanted for incidental cholangiocarcinoma appears good, intermediate- and long-term survival rates are not better than for individuals historically transplanted with known cholangiocarcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Analysis of prognostic factors after curative resection for combined hepatocellular and cholangiocarcinoma].

BACKGROUND/AIMS: Combined hepatocellular and cholangiocarcinoma (HCC-CC) is a rare form of primary liver carcinoma which contains characteristics of both hepatocellular carcinoma and cholangiocarcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Expression of MUC1 and its significance in hepatocellular and cholangiocarcinoma tissue.

AIM: To investigate the relation between MUC1 expression, distribution, and prognosis in hepatocellular and cholangiocarcinoma (HCC and CC) and cirrhotic liver tissues, and their significance in HCC and CC diagnosis.

All consecutive patients with PSC were screened and followed for development of cholangiocarcinoma from 2000 through 2006.

Of 230 patients, 23 developed cytopathologically confirmed cholangiocarcinoma with an annual incidence of 1.2%.

Following this group, conventional cytology, aneuploidy detection by digital imaging analysis, and aneusomy detection by fluorescence in situ hybridization in brushing samples of biliary strictures had a sensitivity of 50%, 57%, and 86%, specificity of 97%, 94%, and 83%, PPV of 86%, 89%, and 80%, and NPV of 83%, 74%, and 88%, respectively, for detecting cholangiocarcinoma.

CONCLUSION: Tumor serology combined with cross-sectional liver imaging may be useful as a screening strategy and cholangiography with cytologic examination is helpful for the diagnosis of cholangiocarcinoma in patients with PSC.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Utility of bile duct brushings for the early detection of cholangiocarcinoma in patients with primary sclerosing cholangitis.

BACKGROUND: In patients with primary sclerosing cholangitis, there are no reliable markers or imaging modalities to detect malignant changes or early cholangiocarcinoma when curative interventions may still be possible.

Three of six patients with marked atypia have undergone transplantation for these abnormal findings, and of these, two had cholangiocarcinoma and one had no cancer detected in the explant.

Two patients with benign findings developed cholangiocarcinoma, whereas 29 others have not.

CONCLUSION: Cytopathologic examination of bile duct brushings taken at ERCP may be useful for the early detection of malignant changes in patients with primary sclerosing cholangitis.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] PBK/TOPK in the differential diagnosis of cholangiocarcinoma from hepatocellular carcinoma and its involvement in prognosis of human cholangiocarcinoma.

In this study, we analyzed PBK/TOPK expression in hepatic primary tumor and explored its role in cholangiocarcinoma biology.

The protein, mRNA of PBK/TOPK, and cell cycle of cholangiocarcinoma cell line after PBK/TOPK suppression with small interfere RNA were studied by Western blot, semiquantitative reverse transcriptase-polymerase chain reaction, and flow cytometry, respectively.

PBK/TOPK was usually expressed in normal bile duct epithelial cells and much more frequently expressed in cholangiocarcinoma (68/74) but never expressed in hepatocytes and hepatocellular carcinomas (0/33).

PBK/TOPK down-regulation was related to the poor prognosis of patients with cholangiocarcinoma (P = .013).

Epidermal growth factor can enhance PBK/TOPK expression in cholangiocarcinoma QBC 939 cells, but suppression of PBK/TOPK in the cells did not affect their proliferation.

PBK/TOPK protein could serve as a useful indicator for histopathologic differentiation between cholangiocarcinoma and hepatocellular carcinomas and the low expression of PBK/TOPK is predicative of poor survival in cholangiocarcinoma patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] A phase I study of intravenous (IV) milataxel in combination with carboplatin in adult patients with advanced malignant solid tumors.

The primary objective of this study was to determine the MTD when MXL was given intravenously in combination with a fixed dose (AUC=6) of carboplatin (C) every 21 days in subjects with advanced malignant solid tumors.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

AIM: To report the prevalence and outcome of cholangiocarcinoma arising in primary sclerosing cholangitis for a British tertiary referral centre.

METHODS: All patients diagnosed with primary sclerosing cholangitis and concurrent cholangiocarcinoma were identified from a prospectively maintained departmental database, and the mode of presentation, management and outcome were determined.

RESULTS: Of 370 patients with primary sclerosing cholangitis, 48 patients (13%) were diagnosed with a cholangiocarcinoma within a median time of 0.51 months (range: 0-73.12) from presentation to the unit.

CONCLUSIONS: Cholangiocarcinoma is a common finding in primary sclerosing cholangitis and regular screening of this cohort of patients at referring centres is advocated to detect early tumours, as surgical treatment at an early stage offers significantly better outcomes for this cohort of patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Brachytherapy in the treatment of cholangiocarcinoma.

METHODS AND MATERIALS: Using the Surveillance, Epidemiology and End Results database, a total of 193 patients with cholangiocarcinoma treated with brachytherapy were identified for the period 1988-2003.

The primary analysis compared patients treated with brachytherapy (with or without external-beam radiation) with those who did not receive radiation.

These data strongly support a metaplasia-low-grade dysplasia-high-grade dysplasia-carcinoma sequence in PSC-associated CCA, and underscore the known lack of relationship between patient age and PSC duration in the development of CCA.

[Title] The incidence of cholangiocarcinoma in primary sclerosing cholangitis after long-time treatment with ursodeoxycholic acid.

Ursodeoxycholic acid may possibly influence the incidence of cholangiocarcinoma in man.

The aim of this study was to evaluate the incidence rate of cholangiocarcinoma in a large group of primary sclerosing cholangitis patients after long-time treatment with ursodeoxycholic acid.

PATIENTS AND METHODS: From May 1987 up to May 2005 a total of 150 patients with primary sclerosing cholangitis but without evidence of cholangiocarcinoma at entry were included in the study.

Altogether five patients developed a cholangiocarcinoma during treatment yielding a rate of 3.3%.

The patients developed 0.58 cholangiocarcinoma per 100 patient-years in years 0-2.5, 0.59 cholangiocarcinoma in years 2.5-8.5, and no cholangiocarcinoma thereafter up to 18 years after entry into the study.

The Kaplan-Meier estimate of cholangiocarcinoma incidence during ursodeoxycholic acid treatment reached a plateau after 8.3 years.

SUMMARY AND CONCLUSION: The annual incidence rate of cholangiocarcinoma in primary sclerosing cholangitis treated with ursodeoxycholic acid is lower than expected and decreases with time of treatment.

Microscopically, we classified the cases into the following three categories according to the arrangement of the hepatocellular carcinoma and cholangiocarcinoma components;.

(1) Type I in which hepatocellular carcinoma and cholangiocarcinoma formed nodules that could easily be distinguished from each other, (2) Type II in which the both components were finely mixed, so that the two components were almost indistinguishable, and (3) Type III in which the tumors had lobular structures with hepatocellular carcinomas existing centrally and cholangiocarcinomas existing peripherally.

In one case of type I, well differentiated hepatocellular carcinoma demonstrated cholangiocarcinoma in "nodules-in-nodules" fashion.

The average of Ki-67 labeling index of hepatocellular carcinoma component of combined hepatocellular and cholangiocarcinoma was 4.4 +/- 3.4% and the index of cholangiocarcinoma component was 11.0 +/- 8.5%, which is significantly higher than that of the hepatocellular carcinoma component.

In one case, the cholangiocarcinoma component was positive for p53, but the hepatocellular carcinoma component was negative.

In the other 4 cases, both the hepatocellular carcinoma and cholangiocarcinoma components were positive.

Metaplasia of hepatocellular carcinoma to intrahepatic cholangiocarcinoma is assumed to be one of the pathogenic pathways of combined hepatocellular and cholangiocarcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Combined hepatocellular and cholangiocarcinoma with sarcomatous transformation was first recognized in Ramathibodi Hospital in 2005.

This variant of carcinoma has been increasingly reported particularly from Asian countries.

It is suggested that the recent change of the Thai peoples' life style to an increased consumption of fast foods containing food preservatives especially nitrate or nitrite, the nitrosamine precursor may allow heavy exposure(s) to the chemical carcinogen(s) i.e. nitrosamine(s) leading to sarcomatous transformation of the carcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Surgical treatments and prognoses of patients with combined hepatocellular carcinoma and cholangiocarcinoma.

BACKGROUND: Combined hepatocellular carcinoma and cholangiocarcinoma is a very rare form of primary liver cancer containing components of both tumor types.

PATIENTS AND METHODS: Of the 2427 patients who underwent hepatectomy or liver transplantation because of a primary hepatic malignancy from January 1989 to July 2006 at the Asan Medical Center, Seoul, Korea, 29 had hepatocellular carcinoma and cholangiocarcinoma as a single mixed or transitional tumor.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

OBJECTIVE: To determine whether the computed tomographic (CT) findings of primary and recurrent combined hepatocellular-cholangiocarcinoma (HCC-CC) can predict the main tumor component on histopathologic examination, and to describe the recurrence patterns of HCC-CC after surgery.

The main features of the primary and recurrent tumors on CT and the pathological findings were classified as hepatocellular carcinoma (HCC)-dominant and cholangiocarcinoma (CC)-dominant groups.

The purpose of this study was to assess the diagnostic value of PET-CT in relation to a conventional imaging modality, multidetector row CT (MDCT), for patients with gallbladder cancer and cholangiocarcinoma.

METHODS: Ninety-nine patients with suspected gallbladder cancer and cholangiocarcinoma who underwent both PET-CT and MDCT for initial staging were included in our study.

The results of these two imaging modalities for evaluating primary tumors, regional lymph nodes and distant metastases were compared with the final diagnoses based on pathological or clinical findings.

The overall values for the sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs) and the accuracies of PET-CT and MDCT for the detection of a primary tumor were 90.2, 70.6, 93.7, 60.0, 86.9% and 84.2, 70.6, 93.2, 48.0, 81.8%, respectively.

PET-CT demonstrated no significant advantage over MDCT for the diagnosis of a primary tumor.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Phosphatase of regenerating liver (PRL)-3 is involved in the metastasis of various tumors, but the expression of PRL-3 and its possible role in primary intrahepatic cholangiocarcinoma (ICC) has not been reported yet.

RESULTS: After a median follow-up period of 28 months after primary liver resection (12-69 months), seven patients (54%) are still alive and three of these patients (23% of the entire cohort) are regarded as disease-free.

One- and three-year survival after primary surgery was 92 and 52%, respectively, with an overall complication rate of 7.6%.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND/AIMS: Preoperative distinction between pancreatic cancer (PC) and extrahepatic cholangiocarcinoma (CC) is desirable due to diverging management options, and to optimize enrollment into neoadjuvant trials.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is a rare subtype of primary liver cancer, and clinicopathological features of cHCC-CC have seldom been reported in detail.

This study was undertaken to explore the diagnosis and clinicopathological characteristics of cHCC-CC in comparison with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC), respectively.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND/AIMS: Primary sclerosing cholangitis (PSC) is associated with a high risk of cholangiocarcinoma.

Our aim was to evaluate the diagnostic value of trypsinogen-1, trypsinogen-2, tumour-associated trypsin inhibitor, human chorionic gonadotropin beta and trypsin-2-alpha(1)-antitrypsin for cholangiocarcinoma and to compare them with CA19-9 and CEA.

METHODS: The study consisted of 84 patients with either PSC or cholangiocarcinoma or both referred for liver transplantation or other liver surgery.

RESULTS: Forty-six patients were transplanted due to PSC; in 3 of the explanted livers cholangiocarcinoma was found incidentally.

Twenty-nine of 38 patients with cholangiocarcinoma were candidates for intervention.

In all, 8 patients had both PSC and cholangiocarcinoma.

Receiver-operating characteristics curve analysis showed that serum trypsinogen-2 had the highest accuracy in differentiating between cholangiocarcinoma and PSC.

Serum trypsinogen-2 also showed the highest accuracy for differentiation between PSC and PSC with simultaneous cholangiocarcinoma with an AUC value of 0.759.

CONCLUSIONS: Our results suggest that serum trypsinogen-2 is a most useful marker for diagnosing patients with cholangiocarcinoma, and it is superior to serum CA19-9 and CEA.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Intrahepatic cholangiocarcinoma metastatic to the ovary: a report of 16 cases of an underemphasized form of secondary tumor in the ovary that may mimic primary neoplasia.

The potential for adenocarcinoma metastatic to the ovary to mimic primary mucinous neoplasms is a well-known issue to surgical pathologists, most of the recent literature emphasizing pancreatic and various other origins for the ovarian metastases.

Microscopically, surface implants were observed in 80% of tumors, multinodular growth in 48%, and infiltrative stromal invasion (including microinvasionlike foci as it would be applied if the tumors were primary) in 86%.

The tumors most closely mimicked primary mucinous neoplasms although a resemblance to other mullerian neoplasms was also seen.

Foci often mimicked mucinous borderline tumors of typical type or with intraepithelial carcinoma and benign-appearing mucinous epithelium was seen in 62% of tumors.

Intrahepatic cholangiocarcinoma should be included in the list of origins of possible ovarian metastatic tumors that mimic primary ovarian mucinous neoplasia, particularly in parts of the world where cholangiocarcinoma of the liver is relatively common.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] KL-6 mucin is a useful immunohistochemical marker for cholangiocarcinoma.

This study aimed to clarify the clinical significance of the expression of KL-6 mucin, a type of MUC1, in primary liver cancer.

Tissue specimens were collected from 21 patients with cholangiocarcinoma (CC), 78 with hepatocellular carcinoma (HCC), and 12 with combined hepatocellular and cholangiocarcinoma (cHCC-CC).

Similar selectivity of KL-6 staining was also observed in the cHCC-CC specimens, and the cholangiocellular tissue could be clearly delineated by KL-6 staining.

In contrast, 79.5% of HCC specimens and 25.0% of cHCC-CC specimens were positive for Hep1 in the hepatocellular tissues, while none of the CC or cHCC-CC specimens were positive in the cholangiocellular tissues.

Staining for CK7 was positive in 95.2% of CC and 35.9% of HCC specimens, while 58.3 and 25.0% of cHCC-CC specimens displayed positivity for CK7 in the cholangiocellular and hepatocellular tissues, respectively.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The aim of this study was to develop TaqMan real-time PCR assay that detected Opisthorchis viverrini DNA from 18 normal and 18 tumor tissue specimens from Thai patients with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA), who underwent liver resection from October 2005 to May 2006.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Surgical treatment of hilar cholangiocarcinoma in the new era: the Asan experience.

BACKGROUND/PURPOSE: Both curative resection and minimized in-hospital mortality offer the only chance of long-term survival in patients with hilar cholangiocarcinoma.

The reported resectability rates for hilar cholangiocarcinoma have increased by virtue of combined major hepatectomy, but this procedure is technically demanding and still associated with a significant morbidity and mortality that must be carefully balanced against the chances of long-term survival.

METHODS: Between January 2001 and December 2008, 350 patients with hilar cholangiocarcinoma underwent exploration for the purpose of potentially curative resection, of whom 302 (86.3%) were resected in the Department of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine.

Liver transplantation was not performed as primary treatment for hilar cholangiocarcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Dynamic FDG-PET is useful for detection of cholangiocarcinoma in patients with PSC listed for liver transplantation.

Five to 15% of patients with primary sclerosing cholangitis (PSC) develop cholangiocarcinoma (CC) with a median survival of 5 to 7 months, an outcome not significantly improved by liver transplantation.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

OBJECTIVE: To analyze clinical typing, pathologic characteristics of hilar cholangiocarcinoma (HCCA) and surgical strategies and their effects on HCCA, and to explore the factors that influence the surgical outcomes and long-term survival.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Liver transplantation after neoadjuvant chemoradiotherapy has emerged as an effective treatment for patients with localized, node-negative, unresectable hilar cholangiocarcinoma (CCA) or CCA arising in the setting of primary sclerosing cholangitis (PSC).

The results suggest TTF-1 cytoplasmic staining, together with CK19, might serve as a useful marker for the diagnosis of primary and metastatic HCC and for the differential diagnosis of HCC from cholangiocarcinoma and MC.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] A case of Muir-Torre syndrome associated with mucinous hepatic cholangiocarcinoma and a novel germline mutation of the MSH2 gene.

We report a case of Muir-Torre syndrome associated with intrahepatic cholangiocarcinoma, a location not previously described, and associated with a novel missense mutation of the MSH2 gene (c.2026T > C), predicted to disrupt the function of the gene.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Combined hepatocellular and cholangiocarcinoma: clinical features and prognostic study in a Thai population.

BACKGROUND/PURPOSE: Combined hepatocellular and cholangiocarcinoma (HCC-CC) is an uncommon subtype of primary liver cancer, the clinicopathological features of which have rarely been reported in detail.

The presence of cholangiocellular differentiation appeared to worsen the prognosis when compared with pure HCC, although this difference did not reach statistical significance.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

OBJECTIVE: To report the experience in surveillance and early detection of cholangiocarcinoma (CC) and in using en bloc total hepatectomy-pancreaticoduodenectomy-orthotopic liver transplantation (OLT-Whipple) to achieve complete eradication of early-stage CC complicating primary sclerosing cholangitis (PSC).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Clinical role of 18F-FDG PET-CT in suspected and potentially operable cholangiocarcinoma: a prospective study compared with conventional imaging.

OBJECTIVES: This study was conducted to evaluate the clinical role of integrated positron emission and computed tomography (PET-CT) in patients with suspected and potentially operable cholangiocarcinoma.

METHODS: Between October 2005 and May 2007, 123 patients with suspected cholangiocarcinoma were enrolled in this study after diagnostic workup, including biliary dynamic computed tomography (CT) and magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) with magnetic resonance (MR) angiography.

PET-CT demonstrated no statistically significant advantage over CT and MRI/MRCP in the diagnosis of primary tumor.

According to different morphologic characteristics of cholangiocarcinoma, PET-CT showed no significant difference in detecting those of mass-forming, periductal-infiltrating, and intraductal-growing types.

Additional use of PET-CT for assessing resectability correctly showed different results from those determined by conventional imaging in 15 (15.9%) of 94 patients with cholangiocarcinoma.

The study was conducted, with institutional review board approval and informed patient consent, to assess the feasibility and diagnostic effectiveness of three-dimensional direct multi-detector row computed tomographic (CT) cholangiography for determining the extent of bile duct invasion by hilar cholangiocarcinoma.

CT cholangiography enabled a correct diagnosis of the extent of ductal involvement at all 11 primary confluence levels and at 18 of the 19 secondary confluence levels.

Three secondary confluences, which could not be analyzed owing to nonopacification or poor opacification, proved to be involved by hilar cholangiocarcinoma.

The authors conclude that three-dimensional direct multi-detector row CT cholangiography is accurate and feasible for defining the extent of ductal invasion by hilar cholangiocarcinoma, especially in patients with preliminary biliary drainage.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Is a raised CA 19-9 level diagnostic for a cholangiocarcinoma in patients with no history of sclerosing cholangitis ?

BACKGROUND/AIM: A cholangiocarcinoma, the second most common primary hepatic malignancy, can present with diagnostic dilemmas.

The aim of this study is to assess the role of CA 19-9 in patients with a cholangiocarcinoma without primary sclerosing cholangitis.

RESULTS: Sensitivity and specificity of CA 19-9 in the diagnosis of a cholangiocarcinoma were 77.9 and 76.3%, respectively, when using a cut-off value of 35 kU/l, while sensitivity and specificity were 67.5 and 86.8%, respectively, when the cut-off value was raised to 100 kU/l.

CONCLUSIONS: This study demonstrates that CA 19-9 is a useful adjunct in the diagnosis of cholangiocarcinomas without primary sclerosing cholangitis, especially in the diagnosis of peripheral cholangiocarcinomas.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Clinical and pathological features of Allen's type C classification of resected combined hepatocellular and cholangiocarcinoma: a comparative study with hepatocellular carcinoma and cholangiocellular carcinoma.

The clinical features of Allen's type C of combined hepatocellular and cholangiocarcinoma (cHCC-CC) are not well known.

In this study, we aim to define the clinicopathologic features of cHCC-CC and to evaluate the preoperative diagnosis and surgical treatment results in comparison with those of hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCC).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Little is known about the molecular cytogenetic changes in cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma, and on the prognostic significance of chromosomal imbalances in hepatocellular carcinoma.

Combined losses at 6q and 3p appeared to be highly characteristic for cholangiocarcinoma.

In contrast, combined hepatocellular-cholangiocarcinoma shared frequent +1q (71%), +8q (57%), and -8p (57%) with hepatocellular carcinoma, but a tendency for higher numbers of imbalances with cholangiocarcinoma.

Cholangiocarcinoma is characterized by combined losses at 6q and 3p and a tendency for chromosomal instability.

On the other hand, combined hepatocellular-cholangiocarcinoma may share similar chromosomal changes with both hepatocellular carcinoma and cholangiocarcinoma, as reflected by common hepatocellular carcinoma-like +8q, +1q, and -8p and a tendency for cholangiocarcinoma-like chromosomal instability.

In hepatocellular carcinoma, higher number of gains may prove an adverse prognostic parameter.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The aim of this study was to review a series of patients submitted to hepatectomy for primary intrahepatic lithiasis to evaluate early and late results with an assessment of indications, methods and long-term outcomes.

From January 1992 to December 2007, 40 patients (25 males and 15 females with a mean age of 51 years) underwent surgery for primary intrahepatic lithiasis in our Hepato-biliary Surgery Unit.

A cholangiocarcinoma was found in 4 patients (10%) and only two of these underwent liver resection, while an exploratory laparotomy was performed in the remaining two patients for an unresectable tumour, unexpected before surgery.

Primary intrahepatic lithiasis is diagnosed increasingly in Western countries as a result of the improvement in imaging techniques.

Biliary pain and cholangitis are the most common presenting symptoms, whereas cholangiocarcinoma represents the unfavourable complication of the disease.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Is there a role for cholangioscopy in patients with primary sclerosing cholangitis?

OBJECTIVES: Assess the role of cholangioscopy in primary sclerosing cholangitis for 1) detection of cholangiocarcinoma using cholangioscopy-assisted biopsy 2) detection of stones not seen on cholangiography 3) stone removal with cholangioscopy-directed lithotripsy.

Eight patients have undergone transplant and cholangiocarcinoma was present in the explant of two at 1 and 12 months post-cholangioscopy, respectively.

CONCLUSIONS: This is the first series of patients with primary sclerosing cholangitis undergoing cholangioscopy for the evaluation of dominant strictures and cholangioscopy-directed stone therapy with demonstrable clinical benefits.

Despite the use of cholangioscopy, diagnosis of cholangiocarcinoma remains technically challenging.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: The purpose of this prospective study was to investigate whether amphotericin B (AmB) had any potential role in the systemic chemotherapy of primary hepatic malignancy using cancer cells collected by the authors' method of primary culture.

METHODS: The specimens obtained by ultrasound-guided fine-needle aspiration biopsy (22 G) from 15 patients with hepatocellular carcinoma (HCC) and one with cholangiocarcinoma were plated into culture flask without disaggregation by trypsin-ethylenediamine tetra-acetic acid solution.

Six patients with HCC and one patient with cholangiocarcinoma (7/16, 44%) had successful culture and the cancer cells at the 4th passage were continuously exposed to therapeutic ranges of epirubicin (0, 0.5, 1.0, 1.5, 2.0 microg/mL) with or without the combination of 2.5 microg/mL AmB for 24 h. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was applied to evaluate the effects of the drugs.

RESULTS: Addition of AmB showed no influence on epirubicin cytotoxicity in two patients (one partial resistant HCC and one epirubicin-sensitive cholangiocarcinoma; 25%), augmentation of the epirubicin cytotoxicity in two patients (one total resistant HCC, partial resistant HA 22T/VGH cell line and one epirubicin-sensitive HCC; 37.5%), and decrease of epirubicin cytotoxicity in the remaining three (one partial resistant and two epirubicin-sensitive HCC; 37.5%).

Application of AmB in the systemic chemotherapy of primary hepatic malignancy should be limited to patients with positive AmB effect evaluated by an in vitro sensitivity test such as the present method.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Changes over a 20-year period in the clinical presentation of primary sclerosing cholangitis in Sweden.

OBJECTIVE: The use of magnetic resonance cholangiopancreaticography (MRCP) as a non-invasive diagnostic tool for primary sclerosing cholangitis (PSC), together with increased clinical awareness of the disease, has led to earlier diagnosis.

The aim of this study was to investigate the clinical presentation of PSC including its association with inflammatory bowel disease (IBD) and the development of cholangiocarcinoma at one centre over an observation period of 20 years.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Little is known about the reproducibility of the pathological diagnosis of primary liver carcinomas.

Therefore, this study aimed to evaluate the worldwide variation in the pathological expert diagnoses of primary liver carcinomas with fibrous stroma in patients who did not have cirrhosis.

RESULTS: The interobserver reproducibility for diagnosis of hepatocellular carcinoma subtypes and cholangiocarcinomas was poor (kappa 0.23-0.52), even when the experts considered that the diagnosis required no additional stains or clinical information.

CONCLUSIONS: The results demonstrate the poor reproducibility among experts of the pathological diagnosis of primary liver carcinomas with fibrous stroma in patients who did not have cirrhosis, and highlight that the systematic use of immunohistochemistry may improve the diagnostic accuracy.